Health Care for All

Shining light on a little-known moment in the struggle for racial justice in the United States, a new hour-long documentary traces the momentous fight to secure equal access to health care for all Americans in the 1960s.

Power to Heal, directed by Charles Burnett, reveals how a broad movement—including black physicians, civil rights activists and volunteers from the executive branch of the federal government—mounted a dramatic coordinated campaign to take advantage of the new Medicare program and passage of the 1964 Civil Rights Act to end legal segregation in U.S. hospitals.

A special advance screening of the movie took place at Harvard Medical School on May 1, before the film’s broadcast premiere on PBS stations nationwide. The showing was followed by a panel discussion with people who were featured in the film and Harvard experts speaking on the damage to health caused by racial bias.

After the screening, the panelists noted that while the events depicted in the film were worthy of praise, there is still much work to be done to ensure equal care for all people.

Alvin Poussaint, professor of psychiatry and faculty associate dean for student affairs at HMS, whose work in the civil rights movement was featured in the film, noted that segregated medicine laid the foundations for disparities in the country long ago and that bias is built into many aspects of the system.

“It’s very hard to undo,” said Poussaint.

He recalled a moment years ago when he visited what was then a recently desegregated hospital. He noticed that all the black people were sitting on what used to be the black side of the waiting room. He asked some of the patients why they didn’t spread out and sit on both sides, mixing in with the white patients.

“‘You see the guard over there, who’s white?’” he recalled patients saying. “‘Do you think his attitude has changed since you took down those signs? Do you think the doctor has changed his mind?’”

“They thought that if they sat on the wrong side of the waiting room, the doctors and nurses would let them die,” Poussaint said.

For most of the history of medical care in the U.S., blacks and other minorities were treated separately from whites. As the civil rights movement took hold, segregationists claimed that medical facilities available to blacks were separate but equal to those available to whites.

The facts showed otherwise, as patients and health care providers interviewed in the film remembered. Often, there was no black hospital available to treat severely injured or critically ill black people, and in segregated hospitals, black patients being treated for tuberculosis were housed in the same room as newborn infants, a potentially deadly practice.

With the creation of the Medicare program in 1966 and passage of the Civil Rights Act of 1964—which required that all institutions receiving federal funding be desegregated—activists and civil rights supporters within the federal government saw an opportunity to transform the system of segregated hospitals throughout the country.

To guarantee compliance with the law, a corps of volunteer inspectors from the U.S. Department of Health, Education, and Welfare spread out across the country to make sure that hospitals were no longer using separate waiting rooms or wards and that all patients had access to the same facilities and care. In a matter of months, the effort culminated with the desegregation of thousands of hospitals across the nation. It was fast, but it wasn’t easy.

One volunteer hospital inspector interviewed in the film said that after he reported a still-segregated hospital for noncompliance, he was threatened and his car was shot up—an outcome that was perhaps unsurprising at a time when volunteers working nearby to register black voters were being murdered by white supremacists, as the film highlighted.

Joan Reede, HMS professor of medicine and dean for diversity and community partnership, welcomed panelists and audience members to the screening. In addition to Poussaint, the panelists included Michael Meltsner, professor of law at Northeastern University, who was also featured in the film, and David Williams, professor of public health at Harvard T.H. Chan School of Public Health and professor of African and African American Studies and Sociology at Harvard University.

Also on the panel was David Smith, author of The Power to Heal: Civil Rights, Medicare, and the Struggle to Transform America’s Health Care System, which became the basis for the film. Smith is professor of health management and policy at Drexel University and professor emeritus of health care management and policy at Temple University

The discussion was moderated by Evelynn Hammonds, chair and professor of the history of science in the Department of the History of Science and professor of African and African American Studies at Harvard University.

Smith said he hopes that the film will highlight lessons that should be part of the national dialogue about health care reform in our country.

“It’s part of our history that has been terribly neglected,” he said, “but it’s very important to preserve, especially now.”

Meltsner said that, while it was important to celebrate the victories portrayed in the film, it is crucial to note that even today black infants in New York City are more than twice as likely to die as white infants.

“Really the most important thing is how much work we still have to do,” he said.

Williams noted that victories were not won when regulations and laws were passed to end segregation.

“It took dedicated action on the part of activists to ensure that the work would be done that needed to be done,” he said.

In the current political climate, with calls to cut access to health care and other aspects of the social safety net, Williams said, this kind of activism may be necessary again.

He also noted that, for those interested in focusing on racial justice in health, there were many avenues they could take, such as preparing and recruiting students of color for careers in biomedicine, fighting for the social safety net and building inclusive communities that support and draw from the power of diversity to improve health equity and social justice across the board.

“The struggle continues,” Williams said. “There’s a lot of room for each of us to be active to ensure the equality that American society promises for all.”